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At my consultation appointment(21/2 weeks ago) my Dr. put me on a Ketosis diet(very high protein, very low carb). I have lost 15 lbs. (usually a good thing) but it has put my BMI just below what is required by my insurance company for surgery approval. I'd hate to gain back some weight to qualify. Any suggestions on what to do?

P.S. I have no comorbidities.

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  • kimmy*custis
    kimmy*custis

    It should be based on your consult weight, not your current weight. Call your doc and find out for sure.

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It should be based on your consult weight, not your current weight. Call your doc and find out for sure.

Yeah, you should be OK. They usually (usually) go by your first weight. They don't go by the weight you are after a pre-op diet, or after any mandatory diet.

I'm in the same boat as you. My insurance doesn't stipulate if my BMI is based on my beginning weight or ending. If I lose another 15 pounds, I'll be below their 40 BMI level. If your surgeon's office has experience with your insurance company, ask the insurance coordinator. The one at my surgeon's office has been great.

Otherwise, you may want to call your insurance company directly and get clarification. You're usually better off asking to speak to someone about bariatrics benefits as sometimes the general CSR's don't have a lot of knowledge. Good luck!

I was told that they go by the initial weight during intake.

I am with the others. My insurance and doctors told me that your intake weight is what they go by. Be sure to check with the doctor and the insurance to see what their rules are on the situation.

good luck

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